Below is the answer to the quiz by Dr. Rishpon presented in the previous issue of Dermatology Practical & Conceptual [2015;5(1):13].
Answer
Balloon cell nevus
Discussion
Balloon cell changes in a nevus correspond to nests of vacuolated melanocytes, caused by enlargement and disintegration of melanosomes [1]. Dermoscopic correlation has been reported as white or yellow globules [2–4]. These globules were confirmed to correlate with junctional and dermal melanocytic nests seen on reflectance confocal microscopy, similar in size and location to the balloon cell nests in histology [2]. It is important to differentiate the white/yellow globules from other structures similar in color and shape, including milia-like cysts and sebaceous glands [3].
This case highlights how clinical and dermoscopic primary morphology serves as a direct correlate of unique histologic features.
Congratulations to Dr. Akhilesh Shukla (drakhilesh89@gmail.com), who was the first to send us the correct answer!
References
- 1.Martinez-Casimiro L, Sánchez Carazo JL, Alegre V. Balloon cell naevus. J Eur Acad Dermatol Venereol. 2009;23(2):236–7. doi: 10.1111/j.1468-3083.2008.02823.x. [DOI] [PubMed] [Google Scholar]
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- 3.Jaimes N, Braun RP, Stolz W, et al. White globules correlate with balloon cell nevi nests. J Am Acad Dermatol. 2011;65:e119–20. doi: 10.1016/j.jaad.2011.03.018. [DOI] [PubMed] [Google Scholar]
- 4.Cinotti E, Perrot JL, Labeille B, et al. Yellow globules in balloon cell naevus. Australas J Dermatol. 2013;54(4):268–70. doi: 10.1111/ajd.12006. [DOI] [PubMed] [Google Scholar]